Thyroid CCS - bingting

[ArchivalUser]

Hi, looking to clarify how to approach thyroid based questions

1. Hyperthyroid presentation

Office: Complete physical
cbc, bmp, ua, lft, tsh, free t4, ekg, troponin

Reschedule in 3 days (TSH low, t4 high)

RAIU, thyroid stimulating receptor antibody, thyroid ultrasound

Reschedule in 3 days

If RAIU is HIGH - Methimazole + propanolol
If RAIU is LOW - Ibuprofen + propanolol

Counsel
Reassurance
Reschedule in 4 weeks
Monitor TSH and free T4

2. Hypothyroid

Office: Complete PE
CBC, BMP, ua, tsh, free t4, lft, ekg, depression index

Reschedule in 3 days (TSH high, free T4 low)

Thyroid ultrasound, Levothyroxine, Counsel, Reassurance, lipid panel

Monitor: TSH and free T4 in 4 weeks

*** Under what circumstances would I resort to FNA?

Thanks.

[ArchivalUser]

Another question: Are antibiotics (Gentamicin+Ceftriaxone) given for all DKA cases or reserved for sepsis cases?

Approaching joint pain diseases: Any feedback please

Office:
Complete PE
cbc, bmp, ua, tsh, esr, lft, anti-CCP, RF, ANA, anti-dsDNA, Xray of affected joint
if swelling: arthrocentesis + synovial fluid
if tender joints: start Acetaminophen
Reschedule in 3 days
Interval f/u
RF: switch to Ibuprofen
OA: continue Acetaminophen
SLE: Prednisone
Infectious: ceftriaxone
Gout: Ibuprofen
Counsel, reassurance, med compliance
Physical therapy
Reschedule in 2 weeks
if persists, add steroids/dmards accordingly
Monitor: ESR

[ArchivalUser]

ok